Nokea
Which of the following changes best described the insulin needs of a client with type 1 diabetes who has just delivered an infant vaginally without complications?
- A. Increase
- B. Decrease
- C. Remain the same as before pregnancy
- D. Remain the same as during pregnancy
Correct Answer: B
Rationale: The placenta produces the hormone human placental lactogen, an insulin antagonist. After birth, the placenta, the major source of insulin resistance, is gone. Insulin needs decrease and women with type 1 diabetes may only need one-half to two-thirds of the prenatal dose.
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When preparing a woman who is 2 days postpartum for discharge, recommendations for which of the following contraceptive methods would be avoided?
- A. Diaphragm
- B. Female condom
- C. Oral contraceptives
- D. Rhythm method
Correct Answer: A
Rationale: A diaphragm should be avoided immediately postpartum because the cervix and vaginal tissues are still healing, and fitting may be inaccurate due to changes in pelvic anatomy. Female condoms, oral contraceptives, and the rhythm method are safer options at this stage.
Which statement accurately describes the importance of birthing person position changes during the second stage of labor?
- A. Position changes have an impact on fetal descent.
- B. Position changes can lead to support person stress.
- C. Fetal descent is solely determined by uterine contractions.
- D. Maintaining a supine position is the safest option.
Correct Answer: A
Rationale: Position changes during the second stage of labor can facilitate fetal descent by optimizing pelvic alignment and gravity.
A multigravida at 38 weeks' gestation is admitted with painless, bright red bleeding and mild contractions every 7 to 10 minutes. Which of the following assessments should be avoided?
- A. Maternal vital signs
- B. Fetal heart rate
- C. Contraction monitoring
- D. Cervical dilation
Correct Answer: D
Rationale: Cervical dilation assessment should be avoided in a multigravida with painless, bright red bleeding, as it suggests placenta previa, and a vaginal exam could exacerbate bleeding. Maternal vital signs, fetal heart rate, and contraction monitoring are safe and necessary.
When describing dizygotic twins to a couple, on which of the following would the nurse base the explanation?
- A. Two ova fertilized by separate sperm
- B. Sharing of a common placenta
- C. Each ova with the same genotype
- D. Sharing of a common chorion
Correct Answer: A
Rationale: Dizygotic (fraternal) twins result from two ova fertilized by separate sperm, leading to genetically distinct siblings. Monozygotic (identical) twins involve a common placenta, same genotype, and common chorion, which does not apply to dizygotic twins.
A nurse in the postpartum unit is caring for a client who has just delivered a newborn infant following a pregnancy with placenta previa. The nurse reviews the plan of care and prepares to monitor the client for which of the following risks associated with placenta previa?
- A. Disseminated intravascular coagulation
- B. Chronic hypertension
- C. Infection
- D. Hemorrhage
Correct Answer: D
Rationale: Because the placenta is implanted in the lower uterine segment, which does not contain as many muscle fibers as the upper uterus, the client is at risk for hemorrhage.